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Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial
CONTEXT: Various intravenous (i.v.) adjuvants have been used along with spinal anesthesia to delay the onset of postoperative pain. AIMS: To compare effects of i.v. dexmedetomidine with midazolam on duration of spinal anesthesia. SETTINGS AND DESIGN: This prospective randomized control trial was con...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545939/ https://www.ncbi.nlm.nih.gov/pubmed/31198255 http://dx.doi.org/10.4103/aer.AER_38_19 |
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author | Sivachalam, Swetha N. Puthenveettil, Nitu Rajan, Sunil Paul, Jerry Kumar, Lakshmi |
author_facet | Sivachalam, Swetha N. Puthenveettil, Nitu Rajan, Sunil Paul, Jerry Kumar, Lakshmi |
author_sort | Sivachalam, Swetha N. |
collection | PubMed |
description | CONTEXT: Various intravenous (i.v.) adjuvants have been used along with spinal anesthesia to delay the onset of postoperative pain. AIMS: To compare effects of i.v. dexmedetomidine with midazolam on duration of spinal anesthesia. SETTINGS AND DESIGN: This prospective randomized control trial was conducted in a tertiary care institution. SUBJECTS AND METHODS: Forty-three patients presenting for elective infraumbilical surgery under spinal anesthesia were randomly allocated into two groups. Group A received a loading dose of 0.5 μg/kg followed by 0.5 μg/kg/h of i.v. dexmedetomidine. Group B received a loading dose of 0.03 mg/kg followed by 0.03 mg/kg/h of i.v. midazolam. Two dermatomal regressions, regression to S(1) level, and sedation score were noted. STATISTICAL ANALYSIS USED: To test the statistical significance of duration of sensory blockade, Mann–Whitney U-test was applied. The incidence of bradycardia and hypotension was analyzed using Pearson's correlation coefficient test. RESULTS: The mean time for two dermatomal regressions was significantly prolonged in Group A (2.3 ± 0.4 h) than Group B (1.6 ± 0.5 h, P = 0.001). Mean time for sensory regression to S(1) dermatome was also prolonged in Group A (5.2 ± 0.83 h) than in Group B (4.4 ± 0.87 h, P = 0.01). Glycopyrrolate was administered in 45% of patients in Group A and 21% in Group B, which was statistically significant (P = 0.039). CONCLUSION: Conscious sedation with i.v. dexmedetomidine at a loading dose of 0.5 μg/kg followed by 0.5 μg/kg/h prolongs duration of spinal anesthesia than i.v. midazolam at a loading dose of 0.03 mg/kg followed by 0.03 mg/kg/h in patients undergoing infraumbilical surgeries. However, dexmedetomidine is associated with higher incidence of hemodynamic instability. |
format | Online Article Text |
id | pubmed-6545939 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-65459392019-06-13 Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial Sivachalam, Swetha N. Puthenveettil, Nitu Rajan, Sunil Paul, Jerry Kumar, Lakshmi Anesth Essays Res Original Article CONTEXT: Various intravenous (i.v.) adjuvants have been used along with spinal anesthesia to delay the onset of postoperative pain. AIMS: To compare effects of i.v. dexmedetomidine with midazolam on duration of spinal anesthesia. SETTINGS AND DESIGN: This prospective randomized control trial was conducted in a tertiary care institution. SUBJECTS AND METHODS: Forty-three patients presenting for elective infraumbilical surgery under spinal anesthesia were randomly allocated into two groups. Group A received a loading dose of 0.5 μg/kg followed by 0.5 μg/kg/h of i.v. dexmedetomidine. Group B received a loading dose of 0.03 mg/kg followed by 0.03 mg/kg/h of i.v. midazolam. Two dermatomal regressions, regression to S(1) level, and sedation score were noted. STATISTICAL ANALYSIS USED: To test the statistical significance of duration of sensory blockade, Mann–Whitney U-test was applied. The incidence of bradycardia and hypotension was analyzed using Pearson's correlation coefficient test. RESULTS: The mean time for two dermatomal regressions was significantly prolonged in Group A (2.3 ± 0.4 h) than Group B (1.6 ± 0.5 h, P = 0.001). Mean time for sensory regression to S(1) dermatome was also prolonged in Group A (5.2 ± 0.83 h) than in Group B (4.4 ± 0.87 h, P = 0.01). Glycopyrrolate was administered in 45% of patients in Group A and 21% in Group B, which was statistically significant (P = 0.039). CONCLUSION: Conscious sedation with i.v. dexmedetomidine at a loading dose of 0.5 μg/kg followed by 0.5 μg/kg/h prolongs duration of spinal anesthesia than i.v. midazolam at a loading dose of 0.03 mg/kg followed by 0.03 mg/kg/h in patients undergoing infraumbilical surgeries. However, dexmedetomidine is associated with higher incidence of hemodynamic instability. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6545939/ /pubmed/31198255 http://dx.doi.org/10.4103/aer.AER_38_19 Text en Copyright: © 2019 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Sivachalam, Swetha N. Puthenveettil, Nitu Rajan, Sunil Paul, Jerry Kumar, Lakshmi Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial |
title | Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial |
title_full | Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial |
title_fullStr | Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial |
title_full_unstemmed | Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial |
title_short | Comparison of Prolongation of Spinal Anesthesia Produced by Intravenous Dexmedetomidine and Midazolam: A Randomized Control Trial |
title_sort | comparison of prolongation of spinal anesthesia produced by intravenous dexmedetomidine and midazolam: a randomized control trial |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545939/ https://www.ncbi.nlm.nih.gov/pubmed/31198255 http://dx.doi.org/10.4103/aer.AER_38_19 |
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